MATERNAL OUTCOME IN PRIMARY CAESAREAN SECTION AND SECONDARY CAESAREAN SECTION– A PROSPECTIVE OBSERVATIONAL STUDY
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2019, Vol 8, Issue 9
Abstract
BACKGROUND Caesarean section (CS) is a surgical intervention for the delivery of foetus. The rapid increase of CS rate throughout the world has become a serious public health concern. Caesarean section has higher maternal surgical risks for current and subsequent pregnancies. There are numerous factors which contribute to decrease in vaginal birth after caesarean section and although repeat caesarean sections are associated with serious morbidity there are only a few studies which assess the risk of placenta praevia and accreta in repeat caesarean section. Thus, this study was undertaken to find out the maternal outcome in those undergoing primary and secondary CS in our population and to find out the common indications of primary caesarean section MATERIALS AND METHODS This is a prospective observational study done in the Department of Obstetrics and Gynaecology, Government Medical College, Thrissur, during the study period from 01.01.2016 to 31.12.2016 in women undergoing primary caesarean section and secondary caesarean section. The data was analysed with SPSS version 17.0 using chi square test taking p value of < 0.05 as statistically significant. RESULTS Our study included 400 subjects, 200 patients each from those who had undergone primary and secondary caesarean section. Most common indications in primary CS group were fetal distress (20%), failed induction (13%), primi, breech (12%) and in secondary CS group were previous CS with unfavourable cervix (63.5%). Adhesions (60.5%) and scar dehiscence (4%) were most common intra op complications in secondary CS group and were statistically significant. PPH (19.8%) was the most common intra operative complication in primary CS group. CONCLUSION In a developing country like India, where the population growth rate is ever increasing, women who have undergone a primary caesarean section must be counselled regarding the complications and possible maternal morbidity in subsequent pregnancies and must be motivated for trial of scar in subsequent pregnancies if there is no contraindication.
Authors and Affiliations
Lissiamma George, Riya Susan Rajan
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